Kashi Clinical Laboratories

Physician's Order Form

Ready to buy? Enter your Provider Email and select panels to get started.
Not a Provider? Fill out our webform: Become a New Provider.

Provider Email (Required)

	$76	APOE Cardiovascular and Alzheimer’s Disease risks
	$148	Abacavir Hypersensitivity HLA-B*57:01
	$148	Addison's Disease HLA-DRB1
	$148	Allopurinol Hypersensitivity HLA-B*58:01
	$148	Ankylosing Spondylitis HLA-B
	$148	Behcet's Disease HLA-B
	$148	Birdshot Chorioretinopathy HLA-A
	$76	CBS Homocysteine and ammonia levels
	$76	COMT Neurotransmitter and estradiol levels · Pain and stress response
	$148	Carbamazepine Hypersensitivity HLA-B*15:02
	$138	Cardiac Health Clotting risk · Blood pressure · Plaque development · Lipid transport · Statin metabolism
	$148	Celiac Disease HLA-DQA1 and HLA-DQB1
	$199	Comprehensive Genetic Cardiac Health · Weight Management · Nutrition · Graceful Aging · Methylation · Mood, Brain and Diabetes Risk
	$148	Graves' Disease HLA-DRB1
	$83	MTHFR Folate metabolism · Cardiovascular and depression risk
	$89	MTHFR & COMT Folate metabolism · Cardiovascular and depression risk · Neurotransmitter and estradiol levels · Pain and stress response
	$195	Mold Sensitivity HLA-DRB1, HLA-DRB345, HLA-DQB1
	$138	Mood Profile Risks associated with developing depression
	$148	Multiple Sclerosis HLA-DRB1
	$148	Narcolepsy HLA-DRB1, HLA-DQB1
	$138	Nutritional Deficiencies Vitamin A · Vitamin B9 (folate) · Vitamin B12 · Vitamin D · Iron
	$245	PGx Comprehensive Cytochrome P450 activity · Metabolism of statins, opioids, warfarin, folate · Risk of thrombosis
	$195	Penicillin Hypersensitivity HLA-B
	$148	Rheumatoid Arthritis HLA-DRB1
	$148	Sjogren's Syndrome HLA-B
	$148	Systemic Lupus Erythematosus HLA DRB1
	$98	Weight Management Carbohydrate and fat metabolism · Meal plans and exercise recommendations

Total: $

New Order

Total	$
APOE	$	76
Abacavir Hypersensitivity	$	148
Addison's Disease	$	148
Allopurinol Hypersensitivity	$	148
Ankylosing Spondylitis	$	148
Behcet's Disease	$	148
Birdshot Chorioretinopathy	$	148
CBS	$	76
COMT	$	76
Carbamazepine Hypersensitivity	$	148
Cardiac Health	$	138
Celiac Disease	$	148
Comprehensive Genetic	$	199
Graves' Disease	$	148
MTHFR	$	83
MTHFR & COMT	$	89
Mold Sensitivity	$	195
Mood Profile	$	138
Multiple Sclerosis	$	148
Narcolepsy	$	148
Nutritional Deficiencies	$	138
PGx Comprehensive	$	245
Penicillin Hypersensitivity	$	195
Rheumatoid Arthritis	$	148
Sjogren's Syndrome	$	148
Systemic Lupus Erythematosus	$	148
Weight Management	$	98
Total After Coupon	$

Provider Name* Provider Phone* Practice Name* NPI *Required

Patient First Name* Patient Last Name* *Required

Address Line 1* Address Line 2 City* State* ZIP Code* *Required

Coupon Code
Any discount will be applied in the next page.

New Order

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Invoice Number
Transaction ID

Thank you for your order. Your payment has been successfully processed and we will fulfill your order within 1 business day. Providers will receive one email confirming this order, and a second secure email containing the report(s). If you are a Provider with an existing Portal Account, your report(s) will also be uploaded to the Portal. If you are a new Provider interested in a Portal account, please contact our Sales Team at 877-879-1815 option 4 to assist you in setting up your account. If you are a Patient placing your own order under your Provider’s account, your provider will receive your report on your behalf. Please follow up with your Provider for your results.

Important Notes to Patient and Physicians:

The genetic tests examine your DNA to determine your “types” for risk assessment for different associated diseases or conditions.
Further information about the specific tests being ordered, including a general description of the tests and of associated diseases or conditions, is available through your health care provider, Kashi Health brochures, or through the Kashi Health website, kashilab.com/providers/health-dna-testing
Before giving consent, you may wish to seek professional genetic counseling.
Your sample will only be used for the genetic testing authorized by your consent and will be destroyed within 60 days of test completion.
A positive test result serves as a predictor, or indication, that you may be predisposed or bear an increased risk for a specific disease or condition. However, no numerical level of certainty has been established for these tests.
A positive result is an indication, not a certainty, that you may be predisposed or bear an increased risk for a specific disease or condition. Therefore, we encourage you to consider further independent testing, as well as checking with your physician and/or also seeking professional genetic counseling.
To maintain confidentiality, the results will only be released to yourself and any individuals you designate with your written consent on the requisition form.

Physician's Order Form

Ready to buy? Enter your Provider Email and select panels to get started. Not a Provider? Fill out our webform: Become a New Provider.

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Ready to buy? Enter your Provider Email and select panels to get started.
Not a Provider? Fill out our webform: Become a New Provider.